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Referral Requirements

Patients must be referred by their physician to participate in the HEROES program. To qualify for the program, patients must have a body mass index exceeding the 85th percentile plus a co-morbid-illness or they must exceed a BMI in the 95th percentile. Patients will also be required to undergo a clinic evaluation by our multi-disciplinary team of healthcare professionals. This initial clinic appointment allows for both our team and the patient and their family to determine if enrollment is appropriate given the duration and requirements of our program and family readiness.

If possible, lab tests will be performed as part of their clinic evaluation. This will require the patient to sustain from eating or drinking 12 hours before the test. The labs can also be scheduled one to two days before the visit, if needed. The labs should be performed at Children's Hospital & Medical Center.

The following is a list of labs that are commonly ordered before or during the clinic evaluation visit:

Complete metabolic profile

Lipid profile

Fasting insulin

Hemoglobin A1C

Thyroid stimulating hormone (TSH)

Free T4

Vitamin D 25 hydroxy

Physician Referral Form

Please print and complete the following physician referral form to have your patient be evaluated for our program.